FURP.ORG / PUBLIC DATA EXPLORER

KABUL NURSING HOMES INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
KABUL NURSING HOMES INC (EIN 43-0834159)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-07-11
IRS object ID
201121929349300817
Schema version
2010v3.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-07-11T16:46:25-05:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1910 E ST LOUIS 200/PO BOX 1190AddressLine1
CitySPRINGFIELDCity
StateMOState
ZIP Code658062523ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN430834159EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1KABUL NURSING HOME INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlKABUNameControl
Phone4179623713Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11000 MAIN STREETAddressLine1
CityCABOOLCity
StateMOState
ZIP Code65689ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameTOM COATSName
TitlePRESIDENT, BOARD OF DIRECTORSTitle
Phone4179623713Phone
Date Signed2011-07-05DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameBrian D ToddName
Phone4178658701Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDEBRA DOTSONNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11000 MAIN STREETAddressLine1
CityCABOOLCity
StateMOState
ZIP Code65689ZIPCode
FieldValueIRS element (for citing)
Gross Receipts5186381GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitekabulnh.comWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1966YearFormation
State Legal DomicileMOStateLegalDomicile
Activity Or Mission DescriptionTO PLAN, BUILD & OPERATE A NURSING CONVALESCENT HOME IN THE CABOOL, MO AREA; TO CARE FOR THE AGED, INFIRM, AFFLICTED & CONVALESCENT, REGARD- LESS OF RACE, COLOR, CREED, SEX, RELIGION, OR ABILITY TO PAY.ActivityOrMissionDescription
Nbr Voting Members Governing Body7NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees195TotalNbrEmployees
Total Nbr Volunteers8TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year4134058ProgramServiceRevenuePriorYear
Program Service Revenue CY5163307ProgramServiceRevenueCY
Investment Income Prior Year7126InvestmentIncomePriorYear
Investment Income Current Year13074InvestmentIncomeCurrentYear
Other Revenue Prior Year519372OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year4660556TotalRevenuePriorYear
Total Revenue Current Year5176381TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year3085145SalariesEtcPriorYear
Salaries Etc Current Year3080827SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year1724543OtherExpensePriorYear
Other Expenses Current Year1864779OtherExpensesCurrentYear
Total Expenses Prior Year4809688TotalExpensesPriorYear
Total Expenses Current Year4945606TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-149132RevenuesLessExpensesPriorYear
Revenues Less Expenses CY230775RevenuesLessExpensesCY
Total Assets BOY3951190TotalAssetsBOY
Total Assets EOY3698878TotalAssetsEOY
Total Liabilities BOY1987728TotalLiabilitiesBOY
Total Liabilities EOY1504641TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1963462NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY2194237NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO PLAN, BUILD AND OPERATE A NURSING AND CONVALESCENT HOME IN THE CABOOL, MISSOURI AREA. SEE SCHEDULE O FOR THE FULL MISSION.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense3188725Expense
Revenue3769793Revenue
DescriptionKABUL NURSING HOME - A FULL SERVICE SKILLED NURSING HOME FOR SHORT & LONG TERM STAYS. KABUL OFFERS A RANGE OF SERVICES INCLUDING: PHYSICAL, SPEECH, & OCCUPATIONAL THERAPY, IN-HOUSE BEAUTY SHOP, SOCIAL SERVICES, PHYSICIAN VISITS, PHARMACY SERVICES & A DIETICIAN, AS WELL AS, NUMEROUS OTHER ITEMS TO HELP MAKE PATIENTS STAY MORE ENJOYABLE. APPROXIMATELY 64 RESIDENTS WERE SERVED DURING THE YEAR.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense622910Expense
Revenue719569Revenue
DescriptionLANDMARK VILLA - A 24-HOUR STAFFED ASSISTED LIVING FACILITY. LANDMARK VILLA OFFERS PRIVATE ROOMS, MEDICATION ADMINISTRATION, FREE LAUNDRY & HOUSEKEEPING SERVICES, THREE BALANCED MEALS A DAY, IN-HOUSE BEAUTY SHOP, DAILY & EXTRACURRICULAR ACTIVITIES, ON-SITE NURSE, EMERGENCY PULL CORDS IN EACH APARTMENT, AND CHURCH SERVICES. APPROXIMATELY 37 RESIDENTS WERE SERVED DURING THE YEAR.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense368197Expense
Revenue673945Revenue
DescriptionPINEVIEW HEIGHTS SENIOR APARTMENTS AND PINEVIEW HEIGHTS RESIDENTIAL CARE - SENIOR INDEPENDENT LIVING WITH INCOME BASED RENT. PINEVIEW HEIGHTS OFFERS SOCIAL SERVICES, IN-HOUSE BEAUTY SHOP, GROCERY DELIVERY, TRANSPORTATION SERVICE, NOON MEAL SERVICE, EMERGENCY PULL CORDS IN EACH APARTMENT, AND DAILY ACTIVITIES. ADDITIONALLY, THE RESIDENTIAL CARE FACILITY IS A 16-BED RESIDENTIAL CARE II FACILITY LOCATED WITHIN THE APARTMENTS. APPROXIMATELY 66 RESIDENTS WERE SERVED DURING THE YEAR.Description
FieldValueIRS element (for citing)
Total Program Service Expense4179832TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Financial Stmt AttachedfalseFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredfalseScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10966NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees195NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members7NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonDEBRA DOTSONNamePerson
Telephone Number4179623713TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11000 MAIN STAddressLine1
CityCABOOLCity
StateMOState
ZIP Code65689ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (8 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
TOM COATS
PRESIDENT1.0XX000
BETTY PERRY
SECRETARY1.0XX000
GARY MAGGARD
VICE-PRESIDENT1.0XX000
ROBERTA TAYLOR
BOARD MEMBER1.0X000
EVELYN WHETSTINE
BOARD MEMBER1.0X000
GARRY BRANDT
TREASURER1.0XX000
SUZANNE CLARK
BOARD MEMBER1.0X000
DEBRA DOTSON
ADMINISTRATOR40.0X6032000
FieldValueIRS element (for citing)
Total Reportable Comp From Org60320TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Description Of ServicesDescriptionOfServicesCompensationCompensationAddress Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCode
SPRINGFIELD GROCER CO INC
FOOD/JANITOR SERVICE100248
BKD LLP
AUDIT & BILLING203838910 E ST LOUIS STSPFDMO658011190
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PATIENT SERVICE62300045474234547423
OTHER OPERATING6230008993889938
RENTAL INCOME531110525946525946
FieldValueIRS element (for citing)
Total Program Service Revenue5163307TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column5074TotalRevenueColumn
Exclusion$5,074ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other18000Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other10000Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other8000Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column8000TotalRevenueColumn
Exclusion$8,000ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column5176381TotalRevenueColumn
Related Or Exempt Function Income5163307RelatedOrExemptFunctionIncome
Exclusion$13,074ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total60320Total
Management And General60320ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total2725605Total
Program Services2479378ProgramServices
Management And General246227ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total70682Total
Program Services63769ProgramServices
Management And General6913ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total224220Total
Program Services200864ProgramServices
Management And General23356ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total2458Total
Management And General2458ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total107178Total
Management And General107178ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total150900Total
Program Services145333ProgramServices
Management And General5567ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total8032Total
Management And General8032ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total202640Total
Program Services113930ProgramServices
Management And General88710ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total23131Total
Management And General23131ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total262153Total
Program Services205302ProgramServices
Management And General56851ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total13685Total
Program Services3419ProgramServices
Management And General10266ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total6549Total
Program Services1795ProgramServices
Management And General4754ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total80521Total
Program Services64541ProgramServices
Management And General15980ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total189461Total
Program Services154606ProgramServices
Management And General34855ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total41459Total
Program Services1744ProgramServices
Management And General39715ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT1853818538
LICENSES, DUES & SUBSCRIPTIONS2502725027
NRFA & NFAC FEES247453247453
MEDICAL SUPPLIES & DRUGS453784453784
REPAIRS & MAINTENANCE26498213515147

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total5312Total
Program Services4025ProgramServices
Management And General1287ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total4945606Total
Program Services4179832ProgramServices
Management And General765774ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY569327BOY
EOY409176EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY326611BOY
EOY360107EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY23926BOY
EOY27516EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY39951BOY
EOY38372EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis8786595LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec5938225LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY2981375BOY
EOY2848370EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY10000BOY
EOY15337EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY3951190BOY
EOY3698878EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY255596BOY
EOY292438EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1700696BOY
EOY1195952EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY31436BOY
EOY16251EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1987728BOY
EOY1504641EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY1953462BOY
EOY2184237EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY10000BOY
EOY10000EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1963462BOY
EOY2194237EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY3951190BOY
EOY3698878EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses230775ReconcilationRevenueExpenses
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewtrueAccountantCompileOrReview
FS AuditedfalseFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years70CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years550CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3650CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year0CurrentTaxYearMinus1Year
Current Tax Year0CurrentTaxYear
Total4270Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5169019CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years5021100CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years5118357CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4653430CurrentTaxYearMinus1Year
Current Tax Year5163307CurrentTaxYear
Total25125213Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5169089CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years5021650CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years5122007CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4653430CurrentTaxYearMinus1Year
Current Tax Year5163307CurrentTaxYear
Total25129483Total
FieldValueIRS element (for citing)
Public Support Total50925129483PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years34415CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years30254CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years13696CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year7126CurrentTaxYearMinus1Year
Current Tax Year5074CurrentTaxYear
Total90565Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years34415CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years30254CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years13696CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year7126CurrentTaxYearMinus1Year
Current Tax Year5074CurrentTaxYear
Total90565Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5203504CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years5051904CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years5135703CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4660556CurrentTaxYearMinus1Year
Current Tax Year5168381CurrentTaxYear
Total25220048Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99641PublicSupportPercentage509
Prior Year Support Percentage0.99571PriorYearSupportPercentage
Investment Income Percentage0.00359InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00429PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$1,404OtherActivitiesAmount
Total Lobbying Expenditures IIB1404TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierOTHER LOBBYING ACTIVITIESIdentifier
Return ReferencePART II-B, LINE 1(I)ReturnReference
ExplanationTHE ORGANIZATION PAYS DUES TO AHCA AND MHCA. A PORTION OF THESE DUES ARE USED FOR LOBBYING PURPOSES.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance10000BeginningOfYearBalance
Investment Earnings Or Losses277InvestmentEarningsOrLosses
Other Expenditures277OtherExpenditures
End Of Year Balance10000EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance10000BeginningOfYearBalance
Investment Earnings Or Losses413InvestmentEarningsOrLosses
Other Expenditures413OtherExpenditures
End Of Year Balance10000EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance10000BeginningOfYearBalance
Investment Earnings Or Losses641InvestmentEarningsOrLosses
Other Expenditures641OtherExpenditures
End Of Year Balance10000EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis352840OtherCostOrOtherBasis
Book Value352840BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis6204636OtherCostOrOtherBasis
Depreciation4237411Depreciation
Book Value1967225BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis843678OtherCostOrOtherBasis
Depreciation544877Depreciation
Book Value298801BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis631074OtherCostOrOtherBasis
Depreciation549305Depreciation
Book Value81769BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis754367OtherCostOrOtherBasis
Depreciation606632Depreciation
Book Value147735BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings2848370TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionTENANT SECURITY DEPOSITSDescription
Amount$16,251Amount
FieldValueIRS element (for citing)
Total Of Amounts16251TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ENDOWMENT FUNDSSCHEDULE D, PART V, LINE 4THIS ENDOWMENT IS A CD, MAINTAINED IN THE AMOUNT OF $10,000, AT THE REQUEST OF THE CONTRIBUTOR OF THE FUNDS. THE CD IS PERPETUAL AND THE INTEREST IS TRANSFERRED ANNUALLY TO AN UNRESTRICTED CASH ACCOUNT THAT IS DESIGNATED TO BE USED FOR THE BENEFIT OF KABUL NURSING HOME.
UNCERTAIN TAX POSITIONSCHEDULE D, PART X, LINE 2MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
VOLUNTEERSFORM 990, PART I, LINE 6THE ORGANIZATION'S BOARD MEMBERS ARE VOLUNTEERS TO THE ORGANIZATION. IN ADDITION, THE ORGANIZATION HAS AN INDIVIDUAL WHO VOLUNTEERS AT THE NURSING HOME FACILITY.
ORGANIZATION'S MISSIONFORM 990, PART III, LINE 1TO PLAN, BUILD AND OPERATE A NURSING AND CONVALESCENT HOME IN THE CABOOL, MISSOURI AREA ON A NON-PROFIT PLAN, TO CARE FOR THE AGED, INFIRM, AFFLICTED AND CONVALESCENT, REGARDLESS OF RACE, COLOR, CREED, SEX, RELIGIOUS AFFILIATION OR ABILITY TO PAY, WITH NO PART OF NET EARNINGS OR ASSETS INURING TO THE BENEFIT OF AN OFFICER, MEMBER, DIRECTOR OR INDIVIDUAL WHATSOEVER.
MEMBERS/STOCKHOLDERSFORM 990, PART VI, SECTION A, LINES 6, 7A & 7BTHE ORGANIZATION'S MEMBERS CONSIST OF DELEGATES FROM THE VARIOUS CIVIC, SERVICES, SOCIAL AND RELIGIOUS CLUBS, ORGANIZATION AND CHURCHES IN AND AROUND THE CITY OF CABOOL, MO. MEMBERS ARE SELECTED BY EACH INDIVIDUAL'S CLUB, ORGANIZATION, OR CHURCH AND THEN SUBMITTED TO THE CORPORATION. THE MEMBERS ELECT THE BOARD OF DIRECTORS. THE MEMBERS HAVE THE POWER TO ALTER, AMEND, OR REPEAL THE BYLAWS.
FORM 990 REVIEW PROCESSFORM 990, PART VI, SECTION B, LINE 11ATHE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM USING THE REVIEWED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ORGANIZATION'S MANAGEMENT. THE RETURN IS REVIEWED BY THE ADMINISTRATOR AND DISTRIBUTED TO ALL BOARD MEMBERS PRIOR TO THE RETURN'S SUBMISSION.
CONFLICT OF INTERESTFORM 990, PART VI, SECTION B, LINE 12CPERSONS COVERED UNDER THIS POLICY ARE DIRECTORS, OFFICERS, AND ALL EMPLOYEES SUCH AS MANAGEMENT AND PURCHASING, WHO CAN INFLUENCE THE ACTIONS OF THE COMPANY. IT SHALL BE THE BOARD, OFFICER'S AND MANAGEMENT'S RESPONSIBILITY TO SCRUTINIZE TRANSACTIONS AND RELATIONSHIPS FOR POTENTIAL CONFLICTS AND TO IMMEDIATELY MAKE SUCH DISCLOSURES BEFORE ANY TRANSACTION IS CONSUMMATED. ANY BOARD MEMBER WITH A CONFLICT OR POTENTIAL CONFLICT OF INTEREST WILL ABSTAIN FROM VOTING ON ANY ISSUE RELATED TO THAT CONFLICT.
ADMINISTRATOR COMPENSATIONFORM 990, PART VI, SECTION B, LINE 15ATHE BOARD OF DIRECTORS ANNUALLY REVIEWS THE COMPENSATION OF THE ADMINISTRATOR. THE REVIEW IS BASED ON PERFORMANCE AND IS DOCUMENTED IN THE BOARD MINUTES.
DOCUMENT DISCLOSUREFORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE FOR VIEWING AT THE FACILITY UPON REQUEST.

Schedule R IRS990ScheduleR

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1THE ERNEST C & ANORA L LOCKWOOD TRUSTBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX HAddressLine1
CityCABOOLCity
StateMOState
ZIP Code65689ZIPCode
FieldValueIRS element (for citing)
Primary ActivityTRUSTPrimaryActivity
Legal Domicile StateMOLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityTRUSTTypeOfEntity
Share Of Total Income277ShareOfTotalIncome
Share Of EOY Assets10000ShareOfEOYAssets
Percentage Ownership1.00000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiestrueReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1THE ERNEST C & ANORA L LOCKWOOD TRUSTBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeATransactionType
Amount Involved277AmountInvolved